Slow elimination of mannitol from human cerebrospinal fluid.
OBJECTIVE
The rise of intracranial pressure above the pre-treatment level (rebound phenomenon) is considered, in part, a consequence of osmotherapeutics penetrating into the intracranial compartments.


METHODS
The kinetics of mannitol in the ventricular CSF were studied in 10 patients with cerebrovascular stroke after a single i.v. infusion of 37.5 g over 15 min.


RESULTS
Maximum mannitol CSF concentrations (mean = 51.1 mg.1-1) were reached 2-12 h after termination of the infusion. Mean t1/2CSF (18.3 h) by far exceeded t1/2S (3.71 h). AUCCSF/AUCS, as a measure of mannitol CSF penetration, ranged from 0.037 to 0.390.


CONCLUSIONS
The slow elimination of mannitol from CSF implies a high risk of accumulation in the central nervous compartments after repeated dosing.
Nau
R
R
Department of Neurology, University of Göttingen, Germany.
Desel
H
H
Lassek
C
C
Thiel
A
A
Schinschke
S
S
Rössing
R
R
Kolenda
H
H
Prange
H W
HW
D000368:Aged; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D008353:Mannitol / Q000134:cerebrospinal fluid*; D008875:Middle Aged
D008353:Mannitol